Abstract
An 80-year-old woman with left common iliac artery occlusion had received right external iliac- left common femoral artery crossover bypass using 6-mm gelatine-coated Dacron graft. Postoperative angiography revealed no evidence of graft stenosis. The left ankle-brachial pressure index (ABI) had improved from 0.49 to 0.84 after the operation. Thirty-two months later, left intermittent claudication appeared again, and the ABI decreased to 0.56. Angiography demonstrated a localized stenosis in a non-anastomotic site, straight portion of the graft. A re-do operation was performed and the fibrotic, funnel-shaped stenotic thrombus was removed. No restenosis was seen 38 months after the second operation and the ABI remains 0.73. The mechanism of stenosis was not clear but turbulent flow caused by temporary compression of the graft, might have led to a clot formation in the non-anastomotic site.
